Felicia Richardson

Coordinates Florida provider enrollment and Medicaid-related activities. Reviews provider documentation and supports NPPES, PECOS, CAQH, and payer enrollment processes.

Analyzes patient medical records to assign accurate ICD-10-CM diagnosis codes for hospice patients. Communicates with clinicians to clarify diagnoses and stays updated on Medicare and state-specific coding regulations.

Provided credentialing and payer follow-up support for a medical billing company specializing in behavioral health and substance abuse facilities. Assisted with re-credentialing, tracked enrollment statuses, and maintained organized records to prevent credentialing-related delays.

Managed provider enrollment with payers and maintained provider files for healthcare professionals. Handled re-credentialing processes and coordinated with healthcare professionals to ensure licensing and certifications were current.

Reviewed and accurately coded medical records for Risk Adjustment and HCC coding guidelines. Ensured compliance with CMS-HCC and other regulatory guidelines, collaborated with providers to resolve discrepancies, and supported audits and credentialing compliance.

Assigned and sequenced medical codes according to government and insurance regulations. Reviewed patient charts for accuracy and assisted with accurate code assignment.

Completed training in medical coding, including medical terminology and anatomy. Applied coding guidelines to code patient services using CPT, ICD-10-CM, ICD-10-PCS, and HCPCS Level II codes.

Bachelor of Science in Health Information with CDIP concentration, expected completion in 2028.

Credentialing Specialist Certification from AAPC, obtained in 2020.

Associate of Arts in Business from the University of Phoenix, completed from 2014 to 2016.

Master of Science in Health Information Technology (Targeted Transfer) at the University of Florida.